MULTI-DETECTOR COMPUTED TOMOGRAPHY ROLE IN LOCAL STAGING OF COLONIC CARCINOMA

Abstract

Background: Pre-operative staging is critical for the treatment and surgical planning of colonic carcinomas. Objectives: To evaluate the role of the contrast enhanced multi-detector computed tomography (CEMDCT) in locoregional staging of the colonic carcinoma in correlation with pathological data as standard. Patients and Methods: The study included 30 consecutive patients diagnosed with colonic carcinoma by biopsy and colonoscopy and referred from the clinic at the National Cancer Institute. MDCT was performed for all patients after being submitted to intravenous non ionic contrast and oral and rectal positive or negative colon opacification. All patients underwent surgery. Tumors were classified with the TNM staging system. The MDCT findings for each patient were recorded and correlated with operative and pathological findings as reference standard. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were calculated. Results: In the detection of extramural invasion, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of CEMDCT were 90%, 70%, 85.7%, 77.8% and 83.3% respectively. Regarding the accuracy of the T staging, the study accurately staged 20 patients (66.6%). In the detection of lymph node status, the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were 84.6%, 70.6%, 68.8%, 85.7% and 76.7% respectively. Conclusions: Contrast enhanced multi-detector computed tomography (CEMDCT) is a sensitive tool in the evaluation of extra-mural invasion, and promising technique in the evaluation of preoperative staging and prognostic factors of colon cancer.